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. 2023 May 11;12(10):3405.
doi: 10.3390/jcm12103405.

Transplantation for Primary Sclerosing Cholangitis: Outcomes and Recurrence

Fuat H Saner  1   2 , Alexandra Frey  3 , Björn-Ole Stüben  1 , Dieter P Hoyer  1 , Katharina Willuweit  3 , Martina Daniel  3 , Jassin Rashidi-Alavieh  3 , Jurgen W Treckmann  1 , Hartmut H Schmidt  3
Affiliations

Transplantation for Primary Sclerosing Cholangitis: Outcomes and Recurrence

Fuat H Saner et al. J Clin Med. .

Abstract

Primary sclerosing cholangitis (PSC) is characterized by inflammation of the whole bile duct system. Liver transplantation is only approved as a curative treatment when it comes to end-stage liver disease. The aim of our study was to assess morbidity, survival rates and PSC recurrence and the impact of donor characteristics in long-term follow-up. This was an IRB-approved retrospective study. A total of 82 patients were identified who were transplanted between January 2010 and December 2021 for PSC. Among these patients, 76 adult liver transplant PSC patients and their corresponding donors were analyzed. Three pediatric cases and three adult patients with a follow-up within <1 year were excluded from further analysis. Median (range) age was 47 years (18-70) with a median (range) lab-MELD of 16 (7-40). Median (range) ICU and hospital stays were 4.6 days (0-147) and 21 days (1-176), respectively. The majority of patients suffered from Crohn's disease or ulcerative colitis as a concomitant comorbidity (65.8%). The ten-year survival rate was 74.6%. A significantly lower lab-MELD score was identified in patients surviving for > 10 years (15 vs. 22, p = 0.004). Most patients (65%) passed in the first year following transplantation, with primary non-function (PNF), sepsis and arterial thrombosis being the most common causes of death. Donor characteristics did not affect patient survival. Patients with PSC show excellent 10-year survival rates. While the lab-MELD score significantly affected long term outcomes, donor characteristics did not affect survival rates.

Keywords: cholestatic liver disease; cirrhosis; disease recurrence; immunosuppression; liver transplantation.

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Conflict of interest statement

FS has served as speaker for CSL Behring, Werfen, Biotest, Merz Pharmaceuticals. No conflicts of interests. The other authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Between 1/2010 and 12/2021, eighty-two patients with PSC were transplanted. Among them, 76 patients were recruited to the study. PSC: primary sclerosing cholangitis; LTX: liver transplantation; Tx: transplantation.
Figure 2
Figure 2
Kaplan–Meier survival analysis.
Figure 3
Figure 3
MELD score: survivors vs. non-survivors. MELD: model for end-stage liver disease, LT: liver transplantation.
See this image and copyright information in PMC

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